Open and Honest Care in your local Trust Open and Honest Report for Black Country Partnership NHS Foundation Trust November 2016
NHS England INFORMATION READER BOX Directorate Medical Commissioning Operations Patients and Information Nursing Trans. & Corp. Ops. Commissioning Strategy Finance Publications Gateway Reference: 03646 Document Purpose Document Name Author Publication Date Target Audience Report NHS England report template OAHC - Combined (for integrated Acute & Community Trusts) NHS England (North) 30 June 2015 CCG Clinical Leaders, Care Trust CEs, Foundation Trust CEs, Directors of Nursing, Communications Leads, NHS Trust CEs Additional Circulation List Description #VALUE! The guidance sets out the Open and Honest report template for integrated Acute & Community Trusts (Combined). Cross Reference Superseded Docs (if applicable) Action Required Timing / Deadlines (if applicable) Contact Details for further information N/A N/A N/A N/A Hazel Richards, Regional Deputy Chief Nurse NHS England (North) 3 Piccadilly Place Manchester M1 3BN (0113) 825 5397 Document Status http://www.england.nhs.uk/ourwork/pe/ohc/ This is a controlled document. Whilst this document may be printed, the electronic version posted on the intranet is the controlled copy. Any printed copies of this document are not controlled. As a controlled document, this document should not be saved onto local or network drives but should always be accessed from the intranet. NB: The National Health Service Commissioning Board was established on 1 October 2012 as an executive non-departmental public body. Since 1 April 2013, the National Health Service Commissioning Board has used the name NHS England for operational purposes. 2
Open and Honest Care Report for: Black Country Partnership NHS Foundation Trust November 2015 Version number: 1.0 First published: November 2015 Updated: N/A Prepared by: Governance Assurance Unit Classification: OFFICIAL 3
Contents Contents... 4 1 Safety... 5 1.1 Safety Thermometer... 5 1.2 Health Care Associated Infections (HCAIs)... 5 1.3 Pressure Ulcers... 6 1.4 Falls... 6 1.5 Safe Staffing... 6 2 Experience... 7 2.1 Patient Experience... 7 2.1.1 The Friends and Family Test... 7 2.1.2 A patient's story... 7 2.2 Staff Experience... 7 2.2.1 The Friends and Family Test... 7 3 Improvement... 8 3.1.1 Improvement Story... 8 4
1 Safety 1.1 Safety Thermometer On one day each month we check to see how many of our patients suffered certain types of harm whilst in our care. We call this the NHS Safety Thermometer. The safety thermometer looks at four harms: pressure ulcers, falls, blood clots and urine infections for those patients who have a urinary catheter in place. This helps us to understand where we need to make improvements. The score below shows the percentage of patients who did not experience any harms. 98.82% of Patients did not experience any of the four harms in this Trust For more information, including a breakdown by category, please visit: http://www.safetythermometer.nhs.uk/ 1.2 Health Care Associated Infections (HCAIs) HCAIs are infections acquired as a result of healthcare interventions. Clostridium difficile (C.difficile) and methicillin-resistant staphylococcus aureus (MRSA) bacteraemia are nationally monitored as we are trying reduce the incidence of these infections. C.difficile is a type of bacterial infection that can affect the digestive system, causing diarrhoea, fever and painful abdominal cramps - and sometimes more serious complications. The bacteria does not normally affect healthy people, but because some antibiotics remove the 'good bacteria' in the gut that protect against C.difficile, people on these antibiotics are at greater risk. Healthcare Acquired Infection Inpatient Services Community Services MRSA Bacteraemia 0 0 C Difficile 0 0 The MRSA bacteria is often carried on the skin and inside the nose and throat. It is a particular problem in hospitals because if it gets into a break in the skin it can cause serious infections and blood poisoning. It is also more difficult to treat than other bacterial infections as it is resistant to a number of widely-used antibiotics. We have a zero tolerance policy to MRSA bacteraemia infections and are working towards reducing C Difficile infections; part of this process is to set improvement targets. If the number of actual cases is greater than the target then we have not improved enough. The table below shows the number of infections we have had this month, plus the improvement target and results for the year to date. 5
1.3 Pressure Ulcers OFFICIAL Pressure ulcers are localised injuries to the skin and/or underlying tissue as a result of pressure. They are sometimes known as bedsores. They can be classified into four categories, with one being the least severe and four being the most severe. The pressure ulcers reported include all validated avoidable/unavoidable pressure ulcers that were obtained at any time during a hospital admission that were not present on initial assessment. 1.4 Falls Severity Inpatient Services Community Services Category 2 1 0 Category 3 0 0 Category 4 0 0 This measure includes all falls in our inpatient settings that resulted in injury, categorised as moderate, severe or death, regardless of cause. This includes avoidable and unavoidable falls sustained at any time during the hospital admission. Severity Inpatient Services Community Services Moderate 1 0 Severe 0 0 Death 0 0 1.5 Safe Staffing Guidelines recently produced by the National Institute for Health & Care Excellence (NICE) make recommendations that focus on safe nursing for adult wards in acute hospitals and maternity settings. As part of the guidance we are required to publish monthly reports showing the registered nurses/midwives and unregistered nurses we have working in each area. The information included in the report shows the monthly planned staffing hours in comparison with the monthly actual staffing hours worked on each ward and/or the percentage of shifts meeting the safe staffing guidelines. In order to view our reports please visit: https://www.england.nhs.uk/ourwork/safestaffing/ 6
2 Experience To measure patient and staff experience we ask a number of questions. The idea is simple: if you like using a certain product or doing business with a particular company you like to share this experience with others. The answers given are used to give a score which is the percentage of patients who responded that they would recommend our service to their friends and family. 2.1 Patient Experience 2.1.1 The Friends and Family Test The Friends and Family Test (FFT) requires all patients to be asked, at periodic points or following discharge, How likely are you to recommend our ward/a&e/service/organisation to friends and family if they needed similar care or treatment? Due to the low number of responses (3) on this occasion, there is no percentage data available. *This result may have changed since publication, for the latest score please visit: http://www.england.nhs.uk/statistics/statistical-work-areas/friends-and-family-test/friends-and-familytest-data/ 2.1.2 A patient's story Learning disability Community services, Dudley I am registered blind. My community nurse sent me to Occupational Therapy. She always chatted with my family and talked it over with me first to make sure it was I wanted to say and do. When a rep had been arranged, she always arrived before the rep to explain things and then stayed after rep had gone and talked it through with me and my family. Because of these visits I got a hospital bed, a comfy chair, wheelchair adaptations, and a sling for the shower and a sleep system. It has made things so much easier all round. My family and carers have benefited as they do not have lean over the bed when doing personal care. Adaptations to the chair have been great when we go out. Sling has made showering so much easier. The comfy chair is so comfy. Everyone has benefitted all rounds. It feels like the staffs have gone pass what their duties were. 2.2 Staff Experience 2.2.1 The Friends and Family Test The Friends and Family Test (FFT) requires staff to be asked, at periodic points: How likely are you to recommend our organisation to friends and family if they 7
needed care or treatment? and How likely are you to recommend our organisation to friends and family as a place to work? 76% of staff would recommend the Trust to friends and family if they needed treatment. 41% of staff would recommend the Trust as a place to work. *This result may have changed since publication, for the latest score please visit: http://www.england.nhs.uk/statistics/statistical-work-areas/friends-and-family-test/friends-and-familytest-data/ 3 Improvement 3.1.1 Improvement Story Service Development/Improvement The Larches Unit is now nearly at full occupancy. The Pines continues to take referrals. The Delayed Discharge Policy is being reviewed. The Functional Exercise Class This is currently a pilot study that is running at Dudley, but hopefully, following an evaluation, the programme can be delivered across the Trust. The Functional Exercise Class (FEC) is run by the Dudley LD Physiotherapy Team. This higher intensity class is designed to improve cardio fitness, balance, co-ordination, lower limb and upper limb strengthening and range of movement. This enables clients to participate within a group setting with a Physiotherapist individually adapting the movements for each client in line with their individual treatment goals. Actions to music include songs such as YMCA for upper limb strengthening which is then followed by One direction lower limb strengthening song and then Cotton Eye Joe to improve balance and co-ordination. The class normally runs for 6 weeks with a Berg Balance Assessment completed pre and post programme to evaluate the effectiveness of the programme. Following completion of the programme clients are then awarded a certificate and a DVD which they can they take home and continue their exercise regime; which is in line with the NICE recommended guidelines to promote education and self-management. 8